Dr Ian McNicoll

Ripple Code4Health

Co-chair openEHR Foundation

What is openEHR?

What is openEHR?An open specification for a health information model

capable of supporting an open platform ecosystem

vendor neutral

technology neutral

licensed to allow open and closed source business models

www.openehr.org

openEHR FoundationNot-for-profit company based at University College, London, UK

Owns the Intellectual Property and has high-level governance role

Elected Management Board

Alliance of Industry and Clinical representatives

openEHR - key goalProvide specifications for an open eHealth platform

keeping the data in any openEHR system completely interoperable

regardless of programming language

regardless of human language

regardless of internal database technology

openEHR - SpecificationsNormal technical specifications with UML diagrams etc

openEHR Reference model how the health data is represented in a patient record

openEHR Archetype object model

how the clinical content definitions are represented separately from the Reference model

Two-level modelling

openEHR: Archetypesopen source computable models of discrete clinical concepts

Familiar components of a health record

Blood pressure, Body weight

Medication order, Family history

Urea, Creatinine results

‘Maximal dataset’ Capture as many clinical perspectives as possible

openEHR: TemplatesTemplates deliver the datasets by aggregating archetypes together

Key clinical endpoint and start point for generation of technical artefacts

i.e. openEHR archetypes and templates can be used directly

Class libraries, Message schema

GUI skeletons, API Profiles

AQL: Information-model querying

Information model querying, independent of the actual database querying

vendor/technology neutral querying

To query an openEHR system you only have to know which archetypes are in use.

However ….Building an openEHR back-end is easy

just follow the specifications

BUT building a high-quality openEHR back-end is hard

must understand archetypes

must support information-model querying

must be fast and flexible

This is not a trivial engineering exercise

The good news…You do not have to build your own openEHR back-end ‘CDR’…

over 10 providers of openEHR CDR services

the APIs are compact and easy to use once you understand the basic concepts

Database Compositions Template validation AQL GDL

supportopen

source Separate product

Think!EHR Oracle Yes Yes Yes Yes Yes

OceanEHR SQL server Yes Yes Yes Yes Yes

DipsEHR SQL Server Yes Yes Yes Yes ?

EtherCIS PostgreSQL Yes Yes In dev In dev Yes Yes

Infinni SQL Server Yes Yes ? Yes

Base24 PostgreSQL Yes Yes In dev In dev Yes

Cabolabs Any SQL Yes Yes Yes Yes

Nousco ? Yes Yes Yes

Privantis PostgreSQL Yes Yes In dev In dev In dev

Medrecord360 ? Yes Yes

Current CDR market

eHealth'('City'of'Moscow''

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Does it scale?

App development

App development

App development

‘open platform’ architecture

open Information Model

App App App

‘open platform’ architecture

open Information Model

openEHR Rest API + AQL

‘open platform’ architecture

openEHR CDR

openEHR Rest API + AQL

‘open platform’ architecture

openEHR CDR

openEHR Rest API + AQL

‘open platform’ architecture

openEHR CDR

openEHR Rest API + AQL

‘open platform’ architecture

openEHR CDR

openEHR Rest API + AQL

‘open platform’ architecture

openEHR CDR

openEHR Rest API + AQL

‘open platform’ architecture

SMARTPlatformsPluggable Webapp

API

HL7 FHIR Clinical Content Exchange

NHS API

‘inVivo’Datastore API

Detailed Clinical Content

Development

Clinical leadership PRSB

Terminology CentreHSCIC

NonopenEHR systems

Archetype+ SNOMED Clinical Content definitions

National ‘standards’ development

National ‘standards’ development

National ‘standards’ development

National ‘standards’ development

National ‘standards’ development

National ‘standards’ development

National ‘standards’ development

Web-based ‘democratised’ collaborative review

Web-based ‘democratised’ collaborative review

Evolutionary standardisation ‘distributed Governance’Implementers

Secondary endorsement

Evolutionary standardisation ‘distributed Governance’Implementers

Secondary endorsement

openEHR: faster, safer app development

Much faster to respond to changes in clinical practice

Interoperability out-of-the-box

Growing ‘open platform’ market Vendor/ tech neutral data models

Vendor/tech neutral data querying